Study Focus

Explore the existing business models for reimbursing pharmacists for clinical care.

Findings

• 1. Expanded access to care and improved health outcomes.

  Developing reimbursement models for pharmacists can expand patient access to care and improve health outcomes, especially in underserved areas.

• 2. System-wide efficiency and quality.

  Leveraging pharmacists as care extenders can boost health plan performance, reduce costs, and improve care coordination and safety.

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Study Focus

Demonstrate the clinical value of integrating the NCPDP/HL7 Pharmacist eCare Plan (PeCP) in pharmacy and medical software systems.

Findings

• This paper explores the implementation and feasibility of patient health information interoperability through the Pharmacist eCare Plan (PeCP), a standard developed by the National Council for Prescription Drug Programs (NCPDP) and Health Level 7 International (HL7) to facilitate seamless data exchange between pharmacies and other healthcare providers. Supported by a grant awarded to the University of Tennessee Health Science Center, College of Pharmacy, the study conducted a proof-of-concept in both a community pharmacy and medical office from January 2021 to December 2024. The intervention targeted patients undergoing transitions of care. The PeCP was implemented using HL7 FHIR technology, enabling efficient, ongoing data sharing after initial IT integration. Findings revealed that prescribers and pharmacists shared a mutual interest in interoperable patient data, recognizing its value in clinical collaboration. Implementation expanded the breadth of accessible medical information, including medication history, diagnoses, and interventions, giving pharmacists a more comprehensive view of patient health and supporting improved care coordination. This study demonstrates the practical feasibility and benefits of pharmacist-driven data interoperability within healthcare teams and utilizing the existing PeCP.

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Study Focus

Finding new and innovative ways to help lower patient cost burdens

Findings

• Analysis showed reduced medication spending per member per month (PMPM) of almost 4% for the analysis group participants (application users). Patient spending on generic medications represented 8.5% less total spending for the analysis group when compared with the control group. Further analysis also showed a 2.1% reduction in non-generic medication spending for the analysis group as compared with the control group. Analysis participants engaged with the application over 5 times on average during the 180-day project period and averaged more than 3.1 RTPB requests per application session. The use of RTPB transactional information by patients to make informed decisions regarding prescription selections has an impact on lowering out-of-pocket patient costs likely leading to increased medication adherence and improved patient experience. This, in turn, would decrease burden for physicians and pharmacists.

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